Question

Which action will the nurse take when caring for a patient with acute respiratory distress syndrome (ARDS) who is receiving continuous lateral rotation therapy (CLRT) while on mechanical ventilation?

A. Periodically assist the patient to the prone position.
B. Avoid the use of pillows or blankets when using CLRT.
C. Assess skin condition frequently to detect skin breakdown.
D. Give enteral feedings during times when CLRT is not being used.

Answer 1

The nurse should frequently assess the skin condition of a patient with ARDS receiving CLRT while on mechanical ventilation to detect and prevent skin breakdown.

Step-by-step explanation:

The appropriate action for a nurse to take when caring for a patient with acute respiratory distress syndrome (ARDS) receiving continuous lateral rotation therapy (CLRT) while on mechanical ventilation would be to assess skin condition frequently to detect skin breakdown. Patients undergoing CLRT are at increased risk for skin breakdown due to the constant movement and pressure. It would be important for the nurse to closely monitor the patient's skin integrity and address any potential issues promptly to maintain skin health and prevent complications. Using pillows or blankets to support and stabilize the patient during CLRT might be contraindicated or recommended based on specific patient needs and hospital protocol. The decision on when to give enteral feedings must be coordinated with the patient's overall treatment plan, including CLRT scheduling and medical status.